Document Detail


Clinical and mechanistic issues in early repolarization of normal variants and lethal arrhythmia syndromes.
MedLine Citation:
PMID:  20883924     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Early repolarization, involving ST-segment elevation and, sometimes, prominent J waves at the QRS-ST junction, has been considered a normal electrocardiographic variant for over 60 years. A growing number of case reports and case-control studies indicate that in some instances, early repolarization patterns are associated with increased risk of idiopathic ventricular fibrillation. Epidemiological evidence indicates a dose effect for the risk of cardiac and sudden death with the extent of J-point elevation. This paper reviews present knowledge regarding the epidemiology, presentation, therapeutic response, and mechanisms characteristic of early repolarization. We highlight major unanswered questions relating to our limited ability to determine which individuals with this common electrocardiographic variant are at risk for sudden death, our incomplete understanding of underlying mechanisms, the inadequate information regarding genetic determinants and therapeutic responses, and the unclear relationship between early repolarization and other conditions involving accelerated repolarization and sudden arrhythmic death such as Brugada and short-QT syndromes. This review paper intends to inform the practicing physician about important clinical issues and to stimulate investigators to address the many unresolved questions in this rapidly evolving field.
Authors:
Begoña Benito; Eduard Guasch; Lena Rivard; Stanley Nattel
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  56     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-04     Completed Date:  2010-10-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1177-86     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Affiliation:
Research Center and Department of Medicine, Montreal Heart Institute and Université de Montréal, Montreal, Quebec, Canada.
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MeSH Terms
Descriptor/Qualifier:
Action Potentials / physiology
Animals
Arrhythmias, Cardiac / complications,  mortality*,  physiopathology*
Death, Sudden, Cardiac* / etiology,  prevention & control
Heart Conduction System / physiology*
Humans
Syndrome
Time Factors
Ventricular Fibrillation / complications,  mortality,  physiopathology
Grant Support
ID/Acronym/Agency:
MOP 68929//Canadian Institutes of Health Research

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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